651
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Curtin GM, Sulsky SI, Van Landingham C, Marano KM, Graves MJ, Ogden MW, Swauger JE. Patterns of menthol cigarette use among current smokers, overall and within demographic strata, based on data from four U.S. government surveys. Regul Toxicol Pharmacol 2014; 70:189-96. [PMID: 24997230 DOI: 10.1016/j.yrtph.2014.06.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/16/2014] [Accepted: 06/18/2014] [Indexed: 10/25/2022]
Abstract
The National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, National Health Interview Survey and Tobacco Use Supplement to the Current Population Survey provide estimates of the proportions of U.S. smokers who currently use menthol cigarettes, overall and within demographic strata. Among adult past-month, regular and daily smokers, menthol cigarette use ranges from 26% to 30%, with statistically higher proportions of female versus male smokers (8-11 percentage points higher) currently using menthol cigarettes. Compared to adult smokers overall, statistically higher proportions of non-Hispanic Black smokers (72-79%) and statistically lower proportions of non-Hispanic White smokers (19-22%) currently use menthol cigarettes, with no differences among smokers of other race/ethnicity groups (18-20% to 28-30%, depending on the survey). Higher proportions of younger adult past-month, regular and daily smokers (aged 18-25years) currently use menthol cigarettes compared to older adult smokers (aged 26-29years and/or ⩾30years); however, differences are small in magnitude, with the vast majority of adult smokers (70-75%) who currently use menthol cigarettes being aged ⩾30years. Comparisons between youth and adult smokers are provided, although data for youth smokers are less available and provide less consistent patterns of menthol cigarette use.
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Affiliation(s)
- Geoffrey M Curtin
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - Sandra I Sulsky
- ENVIRON International Corporation, 28 Amity Street, Suite 2A, Amherst, MA 01002, United States.
| | - Cynthia Van Landingham
- ENVIRON International Corporation, 1900 North 18th Street, Suite 804, Monroe, LA 71201, United States.
| | - Kristin M Marano
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - Monica J Graves
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - Michael W Ogden
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - James E Swauger
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
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652
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Abstract
AIMS To compare the prevalence of diabetes by history and using the fasting plasma glucose (FPG) criterion alone, the HbA1c criterion alone or either one in those not known to have diabetes. METHODS Analysis of NHANES population ≥20years old from 1999 through 2010. RESULTS In those diagnosed by laboratory tests, 86% met the FPG criterion and 53% met the HbA1c criterion. The prevalence of diabetes (history or laboratory test) was significantly increased when the FPG criterion was used compared with the HbA1c criterion in the entire (11.5% vs 10.5%, P=0.018) and Caucasian (10.6% vs 9.2%, P=0.022) populations. In contrast, there were no significant differences in the prevalence when only the FPG criterion was used compared with only the HbA1c criterion in Hispanics (12.9% vs 12.1% P=0.386) and African Americans (14.5 vs 14.3%, P=0.960). Using history and either criterion in those not known to have it, diabetes increased by 61% in this 12year period in adults ≥20years old. CONCLUSIONS Using the FPG rather than the HbA1c criterion to diagnose diabetes in those without a history significantly increased the total prevalence of diabetes in Caucasians but not in African Americans or Hispanics.
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Affiliation(s)
| | - Deyu Pan
- Charles R. Drew University, Los Angeles, California
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653
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Krieger N, Waterman PD, Gryparis A, Coull BA. Black carbon exposure more strongly associated with census tract poverty compared to household income among US black, white, and Latino working class adults in Boston, MA (2003-2010). Environ Pollut 2014; 190:36-42. [PMID: 24704809 PMCID: PMC4701574 DOI: 10.1016/j.envpol.2014.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/13/2014] [Accepted: 03/12/2014] [Indexed: 05/02/2023]
Abstract
We investigated the association of individual-level ambient exposure to black carbon (spatiotemporal model-based estimate for latitude and longitude of residential address) with individual, household, and census tract socioeconomic measures among a study sample comprised of 1757 US urban working class white, black and Latino adults (age 25-64) recruited for two studies conducted in Boston, MA (2003-2004; 2008-2010). Controlling for age, study, and exam date, the estimated average annual black carbon exposure for the year prior to study enrollment at the participants' residential address was directly associated with census tract poverty (beta = 0.373; 95% confidence interval (CI) 0.322, 0.423) but not with annual household income or education; null associations with race/ethnicity became significant only after controlling for socioeconomic position.
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Affiliation(s)
- Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Kresge 717, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Pamela D Waterman
- Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Alexandros Gryparis
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
| | - Brent A Coull
- Department of Biostatistics and Department of Environmental Health, 655 Huntington Avenue, Building II, Room 413, Boston, MA 02115, USA.
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654
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Kim G, Parmelee P, DeCoster J, Bryant AN, Chiriboga DA. The relation between body mass index and self-rated mental health among older adults: do racial/ethnic differences exist? Am J Geriatr Psychiatry 2014; 22:661-9. [PMID: 23567431 PMCID: PMC3989472 DOI: 10.1016/j.jagp.2012.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 06/13/2012] [Accepted: 08/01/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine racial and ethnic differences in the relation between body mass index (BMI) and self-rated mental health (SRMH) among community-dwelling older adults. DESIGN Cross-sectional analyses of nationally representative data from the Collaborative Psychiatric Epidemiology Surveys. SETTING In-person household interviews. PARTICIPANTS Older adults aged 60 and older (N = 2,017), including non-Hispanic white (N = 547), black (N = 814), Hispanic (N = 401), and Asian (N = 255) patients. MEASUREMENTS SRMH was measured with a single item, "How would you rate your own mental health?" BMI categories were underweight (<18.5 kg/m(2)), healthy weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (≥30.0 kg/m(2)). RESULTS A two-way analysis of covariance showed that after controlling for covariates, there was a significant main effect of race/ethnicity on SRMH, but the main effect of BMI was not significant. A significant interaction between BMI and race/ethnicity on SRMH was also found. The linear contrasts showed that white adults had a significant trend showing that SRMH decreased with increases in BMI, whereas black adults had a significant trend showing that SRMH increased with increases in BMI. The linear trends for Hispanic and Asian adults were not significant. CONCLUSIONS There were significant racial/ethnic differences in the relation between BMI and SRMH. Understanding the role of race/ethnicity as a moderator of the relation between BMI and mental health may help improve treatment for older adults with unhealthy weights. Clinical implications are also discussed.
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Affiliation(s)
- Giyeon Kim
- Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, AL; Department of Psychology, The University of Alabama, Tuscaloosa, AL.
| | - Patricia Parmelee
- Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, AL,Department of Psychology, The University of Alabama, Tuscaloosa, AL
| | - Jamie DeCoster
- Center for Advanced Study of Teaching and Learning, University of Virginia, Charlottesville, VA
| | - Ami N. Bryant
- Department of Psychology, The University of Alabama, Tuscaloosa, AL
| | - David A. Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL
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655
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Friedman S, Gibbons J, Galvan C. Declining segregation through the lens of neighborhood quality: does middle-class and affluent status bring equality? Soc Sci Res 2014; 46:155-168. [PMID: 24767597 PMCID: PMC4064587 DOI: 10.1016/j.ssresearch.2014.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 03/04/2014] [Accepted: 03/10/2014] [Indexed: 06/03/2023]
Abstract
Middle- and upper-class status along with suburban residence are together considered symbolic of the American dream. However, the question of whether they mean access to better quality residential environments has gone largely unexplored. This study relies on data from the 2009 panel of the American Housing Survey and focuses on a range of neighborhood conditions, including indicators of physical and social disorder as well as housing value and a neighborhood rating. Contrary to the tenets of the spatial assimilation model, we find that middle-class and affluent status do not consistently lead to superior conditions for all households. Neighborhood circumstances vary considerably based on householder race and ethnicity, with blacks and Hispanics experiencing the greatest disparities from whites. In addition, suburban residence does not attenuate such differences, and in some cases, well-to-do minorities do even worse than whites in neighborhood quality in suburbs.
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Affiliation(s)
- Samantha Friedman
- Samantha Friedman and Joseph Gibbons contributed equally
to this manuscript. Direct correspondence to Samantha Friedman, Department of
Sociology, University at Albany, SUNY, 348 Arts and Sciences Building, 1400
Washington Avenue, Albany, NY 12222 ();
phone (518-442-5458); fax (518-442-4936)
| | - Joseph Gibbons
- Samantha Friedman and Joseph Gibbons contributed equally
to this manuscript. Direct correspondence to Samantha Friedman, Department of
Sociology, University at Albany, SUNY, 348 Arts and Sciences Building, 1400
Washington Avenue, Albany, NY 12222 ();
phone (518-442-5458); fax (518-442-4936)
| | - Chris Galvan
- Population Research Institute, Pennsylvania State University
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656
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Alvanzo AA, Storr CL, Mojtabai R, Green KM, Pacek LR, La Flair LN, Cullen BA, Crum RM. Gender and race/ethnicity differences for initiation of alcohol-related service use among persons with alcohol dependence. Drug Alcohol Depend 2014; 140:48-55. [PMID: 24780308 DOI: 10.1016/j.drugalcdep.2014.03.010] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Prior studies on treatment for alcohol-related problems have yielded mixed results with respect to gender and race/ethnicity disparities. Additionally, little is known about gender and racial differences in time to first alcohol-related service contact amongst persons with alcohol dependence. This study explored gender and race/ethnicity differences for first alcohol-related service utilization in a population-based sample. METHODS Primary analyses were restricted to Blacks, Whites and Hispanics, ages 18-44, with lifetime alcohol dependence (n=3311) in Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions. We compared time to service use among men and women within and across race/ethnicity strata using multivariable Cox proportional hazard methods. RESULTS In the sample of individuals age <45 with alcohol dependence, only 19.5% reported alcohol-related service use. Overall, women were less likely than men to receive alcohol-related services in their lifetime. However, women who did receive treatment were younger at first service utilization and had a shorter interval between drinking onset and service use than men. Gender differences were consistent across racial/ethnic groups but only statistically significant for Whites. There were no appreciable race/ethnicity differences in hazard ratios for alcohol-related service use or time from drinking initiation to first service contact. Results of sensitivity analyses for persons ≥45 years old are discussed. CONCLUSIONS There are important gender differences in receipt of and time from drinking initiation to service utilization among persons with alcohol dependence. Increased recognition of these differences may promote investigation of factors underlying differences and identification of barriers to services.
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657
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Mistry R, Babu GR, Mahapatra T, McCarthy WJ. Cognitive mediators and disparities in the relation between teen depressiveness and smoking. Drug Alcohol Depend 2014; 140:56-62. [PMID: 24768409 DOI: 10.1016/j.drugalcdep.2014.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 02/04/2014] [Accepted: 03/18/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Depressiveness and tobacco use in adolescents are linked, however, there is limited evidence about the cognitive mediators involved and how the role of mediators may differ by gender and racial/ethnic subgroups. METHODS We used a racially/ethnically diverse population-based cross-sectional sample of middle and high school students (n=24,350). Logistic regression models measured the associations of depressiveness with tobacco smoking status, and whether smoking-related knowledge and attitudes (KA) and smoking refusal self-efficacy (SE) attenuated the associations indicating preliminary evidence of mediation. RESULTS Depressiveness was associated with intention to smoke (OR=2.41; 95% CI=2.22, 2.61), experimental smoking (OR=1.93; 95% CI=1.72, 2.17) and established smoking (OR=1.85; 95% CI=1.57, 2.18). The percent attenuation of these associations due to the inclusion of smoking-related KA and smoking refusal SE was 58% for intention to smoke (p<0.001), 68% for experimental smoking (p<0.001) and 86% for established smoking (p<0.001). The association of depressiveness with established smoking did not remain statistically significant (OR=1.16; CI=0.97, 1.40) after including smoking-related KA and smoking refusal SE. Attenuation was more pronounced in males and white students. CONCLUSIONS The results suggest that smoking-related KA and smoking refusal SE attenuated the relation between depressiveness and smoking, indicating that they may serve as mediators of the link between depressiveness and smoking. Tobacco use prevention programs targeting teens with the aim of increasing anti-smoking KA and smoking refusal SE may benefit from addressing depressiveness, particularly by using gender and racially/ethnically tailored strategies. The cross-sectional nature of the data precludes causal inferences.
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Affiliation(s)
- Ritesh Mistry
- Center for Cancer Prevention and Control Research, University of California, Los Angeles, United States; Department of Health Behavior and Health Education, University of Michigan, United States.
| | - Giridhara R Babu
- Department of Epidemiology, University of California, Los Angeles, United States; Indian Institute of Public Health-Hyderabad (Bangalore Wing), Public Health Foundation of India, India
| | - Tanmay Mahapatra
- Department of Epidemiology, University of California, Los Angeles, United States
| | - William J McCarthy
- Center for Cancer Prevention and Control Research, University of California, Los Angeles, United States
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658
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Agénor M, Krieger N, Austin SB, Haneuse S, Gottlieb BR. At the intersection of sexual orientation, race/ethnicity, and cervical cancer screening: assessing Pap test use disparities by sex of sexual partners among black, Latina, and white U.S. women. Soc Sci Med 2014; 116:110-8. [PMID: 24996219 DOI: 10.1016/j.socscimed.2014.06.039] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 06/17/2014] [Accepted: 06/23/2014] [Indexed: 01/06/2023]
Abstract
Understanding how various dimensions of social inequality shape the health of individuals and populations poses a key challenge for public health. Guided by ecosocial theory and intersectionality, we used data from the 2006-2010 National Survey of Family Growth, a national probability sample, to investigate how one dimension of sexual orientation, sex of sexual partners, and race/ethnicity jointly influence Pap test use among black, Latina and white U.S. women aged 21-44 years (N = 8840). We tested for an interaction between sex of sexual partners and race/ethnicity (p = 0.015) and estimated multivariable logistic regression models for each racial/ethnic group, adjusting for socio-demographic factors. The adjusted odds of Pap test use for women with only female sexual partners in the past year were significantly lower than for women with only male sexual partners in the past year among white women (odds ratio [OR] = 0.25, 95% confidence interval [CI]: 0.12,0.52) and may be lower among black women (OR = 0.32, 95% CI: 0.07,1.52); no difference was apparent among Latina women (OR = 1.54, 95% CI: 0.31,7.73). Further, the adjusted odds of Pap test use for women with no sexual partners in the past year were significantly lower than for women with only male sexual partners in the past year among white (OR = 0.30, 95% CI: 0.22,0.41) and black (OR = 0.23, 95% CI: 0.15,0.37) women and marginally lower among Latina women (OR = 0.63, 95% CI: 0.38,1.03). Adding health care indicators to the models completely explained Pap test use disparities for women with only female vs. only male sexual partners among white women and for women with no vs. only male sexual partners among Latina women. Ecosocial theory and intersectionality can be used in tandem to conceptually and operationally elucidate previously unanalyzed health disparities by multiple dimensions of social inequality.
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Affiliation(s)
- Madina Agénor
- Department of Social and Behavioral Sciences, Harvard School of Public Health, USA.
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard School of Public Health, USA
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard School of Public Health, USA; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, USA; Department of Pediatrics, Harvard Medical School, USA
| | | | - Barbara R Gottlieb
- Department of Social and Behavioral Sciences, Harvard School of Public Health, USA; Harvard Medical School, USA; Department of Medicine, Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, USA
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659
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Masters MA, Stanek Krogstrand KL, Eskridge KM, Albrecht JA. Race/ethnicity and income in relation to the home food environment in US youth aged 6 to 19 years. J Acad Nutr Diet 2014; 114:1533-43. [PMID: 24935611 DOI: 10.1016/j.jand.2014.04.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The home food environment is complex and has the potential to influence dietary habit development in young people. Several factors may influence the home food environment, including income and race/ethnicity. OBJECTIVE To examine the relationship of income and race/ethnicity with three home food environment factors (ie, food availability frequency, family meal patterns [frequency of family and home cooked meals], and family food expenditures). DESIGN A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS A total of 5,096 youth aged 6 to 19 years from a nationally representative sample of US individuals participating in NHANES 2007-10. STATISTICAL ANALYSES PERFORMED Prevalence of food availability frequency was assessed for the entire sample, race/ethnicity, poverty income ratio (PIR), and race/ethnicity stratified by PIR. Mean values of family meal patterns and food expenditures were calculated based on race/ethnicity, PIR, and race/ethnicity stratified by PIR using analysis of variance and least squares means. Tests of main effects were used to assess differences in food availability prevalence and mean values of family meal patterns and food expenditures. RESULTS Non-Hispanic whites had the highest prevalence of salty snacks (51.1%±1.5%) and fat-free/low-fat milk (39.2%±1.7%) always available. High-income homes had the highest prevalence of fruits (75.4%±2.4%) and fat-free/low-fat milk (38.4%±2.1%) always available. Differences were found for prevalence of food availability when race/ethnicity was stratified by PIR. Non-Hispanic blacks had the lowest prevalence of fat-free/low-fat milk always available across PIR groups. Differences in mean levels of family meal patterns and food expenditures were found for race/ethnicity, PIR, and race/ethnicity stratified by PIR. CONCLUSIONS Race/ethnicity and PIR appear to influence food availability, family meal patterns, and family food expenditures in homes of youth. Knowledge of factors that influence the home food environment could assist in developing effective strategies to improve food environments for young people.
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660
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Abstract
Physical activity is an important determinant of obesity and overall health for children, but significant race/ethnic and nativity disparities exist in the amount of physical activity that children receive, with immigrant children particularly at risk for low levels of physical activity. In this paper, we examine and compare patterns in physical activity levels for young children of U.S.-born and immigrant mothers from seven race/ethnic and nativity groups, and test whether physical activity is associated with subjective (parent-reported) and objective (U.S. Census) neighborhood measures. The neighborhood measures include parental-reported perceptions of safety and physical and social disorder and objectively defined neighborhood socioeconomic disadvantage and immigrant concentration. Using restricted, geo-coded Early Childhood Longitudinal Study-Kindergarten (ECLS-K) data (N = 17,510) from 1998 to 1999 linked with U.S. Census 2000 data for the children's neighborhoods, we utilize zero-inflated Poisson (ZIP) models to predict the odds of physical inactivity and expected days of physical activity for kindergarten-aged children. Across both outcomes, foreign-born children have lower levels of physical activity compared to U.S.-born white children. This disparity is not attenuated by a child's socioeconomic, family, or neighborhood characteristics. Physical and social disorder is associated with higher odds of physical inactivity, while perceptions of neighborhood safety are associated with increased expected days of physical activity, but not with inactivity. Immigrant concentration is negatively associated with both physical activity outcomes, but its impact on the probability of physical inactivity differs by the child's race/ethnic and nativity group, such that it is particularly detrimental for U.S.-born white children's physical activity. Research interested in improving the physical activity patterns of minority and second-generation immigrant children should consider how neighborhood context differentially impacts the health and physical activity of children from various racial, ethnic and nativity backgrounds.
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661
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Dowd JB, Palermo T, Chyu L, Adam E, McDade TW. Race/ethnic and socioeconomic differences in stress and immune function in The National Longitudinal Study of Adolescent Health. Soc Sci Med 2014; 115:49-55. [PMID: 24946263 DOI: 10.1016/j.socscimed.2014.06.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 05/16/2014] [Accepted: 06/10/2014] [Indexed: 01/08/2023]
Abstract
Stress and immune function may be important mediators of the strong association between social factors and health over the life course, but previous studies have lacked the data to fully explore these links in a population-based sample. This study utilizes data from Waves I-IV of the U.S. National Longitudinal Study of Adolescent Health (Add Health) to test the associations of race/ethnicity and socioeconomic status (SES) with levels of perceived stress and exposure to stressful life events (SLE) among 11,050 adult respondents aged 24-32 in 2008-2009. We further tested whether race/ethnicity and SES were associated with Epstein-Barr Virus (EBV) specific IgG antibodies, an indirect marker of cell-mediated immune function. Finally, we tested whether measures of stress were associated with EBV IgG and whether there was evidence that they explain any associations between race/ethnicity, SES and EBV IgG. We found strong associations between lower SES and higher levels of perceived stress (OR 2.07, 95% CI 1.73-2.48 for < high school vs. college or above) and a high level of stressful life events (OR 7.47, 95% CI 5.59-9.98 for < high school vs. college or above). Blacks had higher odds of a high level of stressful life events compared to whites (OR 2.00, 95% CI 1.63-2.47), but not higher perceived stress (OR 1.11, 95% CI 0.96-1.28). Blacks also had significantly higher EBV levels compared to whites (β = 0.136, p < 0.01), but lower SES was not associated with higher EBV IgG. We found no evidence that stressful life events or perceived stress were associated with EBV IgG in this sample, and thus did not account for racial differences in EBV IgG. These results suggest consistent race/ethnic and SES differences in stressful life events, and confirm race/ethnic differences in markers of immune function that may have health implications across the life course.
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Affiliation(s)
- Jennifer B Dowd
- CUNY School of Public Health, Hunter College, 2180 Third Avenue, New York, NY 10035, USA; CUNY Institute for Demographic Research (CIDR), One Bernard Baruch Way, New York, NY 10010, USA.
| | - Tia Palermo
- Program in Public Health, Department of Preventive Medicine, Stony Brook University (SUNY), Health Sciences Center 3-071, Stony Brook, NY 11794, USA.
| | - Laura Chyu
- Cells to Society: The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
| | - Emma Adam
- School of Education and Social Policy, Northwestern University, 2120 Campus Drive, Evanston, IL 60208, USA; Cells to Society: The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA; Cells to Society: The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
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662
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Bucchianeri MM, Eisenberg ME, Wall MM, Piran N, Neumark-Sztainer D. Multiple types of harassment: associations with emotional well-being and unhealthy behaviors in adolescents. J Adolesc Health 2014; 54:724-9. [PMID: 24411820 PMCID: PMC4107652 DOI: 10.1016/j.jadohealth.2013.10.205] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/30/2013] [Accepted: 10/30/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore relationships between harassment (i.e., race-, weight-, socioeconomic-status (SES)-based, and sexual) and health-related outcomes, including self-esteem, depressive symptoms, body satisfaction, substance use, and self-harm behavior, among diverse adolescents. METHOD Cross-sectional analysis using data from a population-based study of adolescents participating in Eating and Activity in Teens 2010 (EAT 2010) (n = 2,793; mean age = 14.4 years). Sample was socioeconomically and racially/ethnically diverse (81% racial/ethnic minority; 54% low or low-middle income). RESULTS Having experienced any type of harassment was significantly associated with poor self-esteem, depressive symptoms, low body satisfaction, substance use, and self-harm behaviors. After mutually adjusting for other types of harassment, weight-based harassment was consistently associated with lower self-esteem and lower body satisfaction in both genders (standardized βs ranged in magnitude from .39 to .48); sexual harassment was significantly associated with self-harm and substance use in both genders (ORs: 1.64 to 2.92); and both weight-based and sexual harassment were significantly associated with depressive symptoms among girls (standardized βs = .34 and .37). Increases in the number of different harassment types reported by adolescents were associated with elevated risk for alcohol, cigarette, and marijuana use, and self-harm (ORs: 1.22 to 1.42) as well as emotional well-being (standardized βs: .13 to .26). CONCLUSIONS Having had any harassment experience was significantly associated with a variety of negative health and well-being outcomes among adolescents, and risk for these outcomes increases with the number of harassment types an adolescent experiences. Early detection and intervention to decrease harassment experiences may be particularly important in mitigating psychological and behavioral harm among adolescents.
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Affiliation(s)
- Michaela M. Bucchianeri
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Marla E. Eisenberg
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota,Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Medical School, University of Minnesota
| | - Melanie M. Wall
- Departments of Biostatistics and Psychiatry, Columbia University
| | - Niva Piran
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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663
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Abstract
OBJECTIVE Cross-sectional studies have found that low-income and racial/ethnic minority women are more likely to use female sterilization and less likely to rely on a partner's vasectomy than women with higher incomes and whites. However, studies of pregnant and postpartum women report that racial/ethnic minorities, particularly low-income minority women, face greater barriers in obtaining a sterilization than do whites and those with higher incomes. In this paper, we address this apparent contradiction by examining the likelihood a woman gets a sterilization following each delivery, which removes from the comparison any difference in the number of births she has experienced. STUDY DESIGN Using the 2006-2010 National Survey of Family Growth, we fit multivariable-adjusted logistic and Cox regression models to estimate odds ratios and hazard ratios for getting a postpartum or interval sterilization, respectively, according to race/ethnicity and insurance status. RESULTS Women's chances of obtaining a sterilization varied by both race/ethnicity and insurance. Among women with Medicaid, whites were more likely to use female sterilization than African Americans and Latinas. Privately insured whites were more likely to rely on vasectomy than African Americans and Latinas, but among women with Medicaid-paid deliveries reliance on vasectomy was low for all racial/ethnic groups. CONCLUSIONS Low-income racial/ethnic minority women are less likely to undergo sterilization following delivery compared to low-income whites and privately insured women of similar parities. This could result from unique barriers to obtaining permanent contraception and could expose women to the risk of future unintended pregnancies. IMPLICATIONS Low-income minorities are less likely to undergo sterilization than low-income whites and privately insured minorities, which may result from barriers to obtaining permanent contraception, and exposes women to unintended pregnancies.
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Affiliation(s)
- Kari White
- Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Joseph E Potter
- Population Research Center, University of Texas at Austin, Austin, TX 78712, USA
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Saloner B, Carson N, Lê Cook B. Explaining racial/ethnic differences in adolescent substance abuse treatment completion in the United States: a decomposition analysis. J Adolesc Health 2014; 54:646-53. [PMID: 24613095 DOI: 10.1016/j.jadohealth.2014.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/24/2013] [Accepted: 01/01/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To identify contributors to racial/ethnic differences in completion of alcohol and marijuana treatment among adolescents at publicly funded providers. METHODS The 2007 Treatment Episode Data Set provided substance use history, treatment setting, and treatment outcomes for youth aged 12-17 years from five racial/ethnic groups (N = 67,060). Individual-level records were linked to variables measuring the social context and service system characteristics of the metropolitan area. We implemented nonlinear regression decomposition to identify variables that explained minority-white differences. RESULTS Black and Hispanic youth were significantly less likely than whites to complete treatment for both alcohol and marijuana. Completion rates were similar for whites, Native Americans, and Asian-Americans, however. Differences in predictor variables explained 12.7% of the black-white alcohol treatment gap and 7.6% of the marijuana treatment gap. In contrast, predictors explained 57.4% of the Hispanic-white alcohol treatment gap and 19.8% of the marijuana treatment gap. While differences in the distribution of individual-level variables explained little of the completion gaps, metropolitan-level variables substantially contributed to Hispanic-white gaps. For example, racial/ethnic composition of the metropolitan area explained 41.0% of the Hispanic-white alcohol completion gap and 23.2% of the marijuana completion gap. Regional differences in addiction treatment financing (particularly use of Medicaid funding) explained 13.7% of the Hispanic-white alcohol completion gap and 9.8% of the Hispanic-white marijuana treatment completion gap. CONCLUSIONS Factors related to social context are likely to be important contributors to white-minority differences in addiction treatment completion, particularly for Hispanic youth. Increased Medicaid funding, coupled with culturally tailored services, could be particularly beneficial.
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665
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Cote ML, Ruterbusch JJ, Ahmed Q, Bandyopadhyay S, Alosh B, Abdulfatah E, Seward S, Morris R, Ali-Fehmi R. Endometrial cancer in morbidly obese women: do racial disparities affect surgical or survival outcomes? Gynecol Oncol 2014; 133:38-42. [PMID: 24680590 DOI: 10.1016/j.ygyno.2014.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 01/08/2014] [Accepted: 01/11/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Endometrial cancer mortality disproportionately affects black women and whether greater prevalence of obesity plays a role in this disparity is unknown. We examine the effect of race on post-surgical complications, length of stay, and mortality specifically in a morbidly obese population. METHODS Black and white women with endometrial cancer diagnosed from 1996 to 2012 were identified from the University Pathology Group database in Detroit, Michigan, and records were retrospectively reviewed to obtain clinicopathological, demographic, and surgical information. Analysis was limited to those with a body mass index of 40kg/m(2) or greater. Differences in the distribution of variables by race were assessed by chi-squared tests and t-tests. Kaplan-Meier and Cox regression analyses were performed to examine factors associated with mortality. RESULTS 97 white and 89 black morbidly obese women were included in this analysis. Black women were more likely to have type II tumors (33.7% versus 15.5% of white women, p-value=0.003). Hypertension was more prevalent in black women (76.4% versus 58.8%, p-value=0.009), and they had longer hospital stays after surgery despite similar rates of open vs minimally invasive procedures and lymph node dissection (mean days=5.4) compared to whites (mean days=3.5, p-value=0.036). Wound infection was the most common complication (16.5% in whites and 14.4% in blacks, p-value=0.888). Blacks were more likely to suffer other complications, but overall the proportions did not differ by race. In univariate analyses, black women had higher risk of endometrial cancer-related death (p-value=0.090). No racial differences were noted in adjusted survival analyses. CONCLUSION A more complete investigation, incorporating socio-demographic factors, is warranted to understand the effects of morbid obesity and race on endometrial cancer.
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Affiliation(s)
- M L Cote
- Wayne State University School of Medicine, Department of Oncology, Detroit, MI, USA; Karmanos Cancer Institute, Population Studies and Disparities Program, Detroit, MI, USA.
| | - J J Ruterbusch
- Wayne State University School of Medicine, Department of Oncology, Detroit, MI, USA
| | - Q Ahmed
- Wayne State University School of Medicine, Department of Pathology, Detroit, MI, USA
| | - S Bandyopadhyay
- Wayne State University School of Medicine, Department of Pathology, Detroit, MI, USA
| | - B Alosh
- Wayne State University School of Medicine, Department of Pathology, Detroit, MI, USA
| | - E Abdulfatah
- Wayne State University School of Medicine, Department of Pathology, Detroit, MI, USA
| | - S Seward
- Wayne State University School of Medicine, Department of Gynecologic Oncology, Detroit, MI, USA; Karmanos Cancer Institute, Department of Gynecologic Oncology, Detroit, MI, USA
| | - R Morris
- Wayne State University School of Medicine, Department of Gynecologic Oncology, Detroit, MI, USA; Karmanos Cancer Institute, Department of Gynecologic Oncology, Detroit, MI, USA
| | - R Ali-Fehmi
- Wayne State University School of Medicine, Department of Pathology, Detroit, MI, USA
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666
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Bentley-Lewis R, Dawson DL, Wenger JB, Thadhani RI, Roberts DJ. Placental histomorphometry in gestational diabetes mellitus: the relationship between subsequent type 2 diabetes mellitus and race/ethnicity. Am J Clin Pathol 2014; 141:587-92. [PMID: 24619761 DOI: 10.1309/ajcpx81aunfpotll] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES We examined placental histomorphometry in gestational diabetes mellitus (GDM) for factors associated with race/ethnicity and subsequent type 2 diabetes mellitus (T2DM). METHODS We identified 124 placentas from singleton, full-term live births whose mothers had clinically defined GDM and self-reported race/ethnicity. Clinical and placental diagnoses were abstracted from medical records. RESULTS Forty-eight white and 76 nonwhite women were followed for 4.1 years (median, range 0.0-8.9 years). White women developed less T2DM (12.5% vs 35.5%; P = .005) but had higher systolic (mean ± SD, 116 ± 13 vs 109 ± 11 mm Hg; P < .001) and diastolic (71 ± 9 vs 68 ± 7 mm Hg; P = .02) blood pressure, more smoking (35.4% vs 10.5%; P = .004), and more chorangiosis (52.1% vs 30.3%; P = .02) than nonwhite women. CONCLUSIONS Although more nonwhite women developed T2DM, more white women had chorangiosis, possibly secondary to the higher percentage of smokers among them. Further study is necessary to elucidate the relationship among chorangiosis, subsequent maternal T2DM, and race.
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Affiliation(s)
| | - Deanna L. Dawson
- Medicine/Diabetes Unit, Massachusetts General Hospital, Boston, MA
| | - Julia B. Wenger
- Medicine/Division of Nephrology, Massachusetts General Hospital, Boston, MA
| | - Ravi I. Thadhani
- Medicine/Division of Nephrology, Massachusetts General Hospital, Boston, MA
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667
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Yang TC, Shoff C, Noah AJ, Black N, Sparks CS. Racial segregation and maternal smoking during pregnancy: a multilevel analysis using the racial segregation interaction index. Soc Sci Med 2014; 107:26-36. [PMID: 24602968 PMCID: PMC4029363 DOI: 10.1016/j.socscimed.2014.01.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 01/16/2014] [Accepted: 01/19/2014] [Indexed: 11/20/2022]
Abstract
Drawing from both the place stratification and ethnic enclave perspectives, we use multilevel modeling to investigate the relationships between women's race/ethnicity (i.e., non-Hispanic white, non-Hispanic black, Asian, and Hispanic) and maternal smoking during pregnancy, and examine if these relationships are moderated by racial segregation in the continental United States. The results show that increased interaction with whites is associated with increased probability of maternal smoking during pregnancy, and racial segregation moderates the relationships between race/ethnicity and maternal smoking. Specifically, living in a less racially segregated area is related to a lower probability of smoking during pregnancy for black women, but it could double and almost triple the probability of smoking for Asian women and Hispanic women, respectively. Our findings provide empirical evidence for both the place stratification and ethnic enclave perspectives.
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Affiliation(s)
- Tse-Chuan Yang
- Department of Sociology, Center for Social and Demographic Analysis, University at Albany, State University of New York, USA
| | - Carla Shoff
- Centers for Medicare and Medicaid Services, USA.
| | - Aggie J Noah
- Department of Sociology, Population Research Institute, Pennsylvania State University, USA
| | - Nyesha Black
- Department of Sociology, Population Research Institute, Pennsylvania State University, USA
| | - Corey S Sparks
- Department of Demography, University of Texas San Antonio, USA
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668
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Braun UK, Beyth RJ, Ford ME, Espadas D, McCullough LB. Decision-making styles of seriously ill male Veterans for end-of-life care: Autonomists, Altruists, Authorizers, Absolute Trusters, and Avoiders. Patient Educ Couns 2014; 94:334-341. [PMID: 24365071 DOI: 10.1016/j.pec.2013.10.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 10/05/2013] [Accepted: 10/26/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To describe self-reported decision-making styles and associated pathways through end-of-life (EOL) decision-making for African-American, Caucasian, and Hispanic seriously ill male Veterans, and to examine potential relationships of race/ethnicity on these styles. METHODS Forty-four African American, White, and Hispanic male Veterans with advanced serious illnesses participated in 8 racially/ethnically homogenous focus groups. Transcripts were qualitatively analyzed to identify major themes, with particular attention to themes that might be unique to each of the racial/ethnic groups. RESULTS Patients described two main decision-making styles, deciding for oneself and letting others decide, leading to five variants that we labeled Autonomists, Altruists, Authorizers, Absolute Trusters, and Avoiders. These variants, with exception of avoiders (not found among White patients), were found across all racial/ethnic groups. The variants suggested different 'implementation strategies', i.e., how clear patients made decisions and whether or not they then effectively communicated them. CONCLUSION These identified decision-making styles and variants generate strategies for clinicians to better address individualized advance care planning. PRACTICE IMPLICATIONS Physicians should elicit seriously ill patients' decision-making styles and consider potential implementation strategies these styles may generate, thus tailoring individualized recommendations to assist patients in their advance care planning. Patient-centered EOL decision-making can ensure that patient preferences are upheld.
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Affiliation(s)
- Ursula K Braun
- Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, USA; Baylor College of Medicine, Department of Medicine, Section of Geriatrics, Houston, USA.
| | - Rebecca J Beyth
- Geriatric Research Education Clinical Center, NF/SGVHS, Department of Medicine, University of Florida College of Medicine, Gainesville, USA
| | - Marvella E Ford
- Department of Biostatistics, Bioinformatics, and Epidemiology and Cancer Disparities, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
| | - Donna Espadas
- Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, USA
| | - Laurence B McCullough
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, USA
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Fader JJ, Kurlychek MC, Morgan KA. The color of juvenile justice: racial disparities in dispositional decisions. Soc Sci Res 2014; 44:126-40. [PMID: 24468439 DOI: 10.1016/j.ssresearch.2013.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 10/08/2013] [Accepted: 11/23/2013] [Indexed: 05/17/2023]
Abstract
Existing research on dispositional decisions typically models the outcome as merely placed or not placed. However, this does not accurately reflect the wide variation in residential options available to juvenile court actors. In this research, we combine data from ProDES, which tracks adjudicated youth in Philadelphia, with data from the Program Design Inventory, which describes over 100 intervention programs, to further examine the factors that influence court actors' decision making in selecting an appropriate program for a juvenile offender. We find that even after controlling for legal and needs-based factors, race continues to exert a significant influence, with decision makers being significantly more likely to commit minority youth to facilities using physical regimen as their primary modality and reserving smaller, therapeutic facilities for their white counterparts. Using focal concerns theory as an explanatory lens, we suggest that court actors in this jurisdiction employ a racialized perceptual shorthand of youthful offenders that attributes both higher levels of blame and lower evaluations of reformability to minority youth.
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Affiliation(s)
- Jamie J Fader
- School of Criminal Justice, University at Albany, 135 Western Avenue, Albany, NY 12222, United States.
| | - Megan C Kurlychek
- School of Criminal Justice, University at Albany, 135 Western Avenue, Albany, NY 12222, United States.
| | - Kirstin A Morgan
- School of Criminal Justice, University at Albany, 135 Western Avenue, Albany, NY 12222, United States.
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670
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Castro-Diehl C, Diez Roux AV, Seeman T, Shea S, Shrager S, Tadros S. Associations of socioeconomic and psychosocial factors with urinary measures of cortisol and catecholamines in the Multi-Ethnic Study of Atherosclerosis (MESA). Psychoneuroendocrinology 2014; 41:132-41. [PMID: 24495614 DOI: 10.1016/j.psyneuen.2013.12.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 11/25/2013] [Accepted: 12/19/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Stress hormones have been hypothesized to contribute to the social patterning of cardiovascular disease but evidence of differences in hormone levels across social groups is scant. PURPOSE To examine the associations of socioeconomic and psychosocial factors with urinary levels of cortisol and catecholamines and determine whether these associations are modified by race/ethnicity. METHODS Measures of cortisol, epinephrine, norepinephrine and dopamine were obtained on 12-h overnight urine specimens from 942 White, African American and Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Linear regression was used to examine associations of income-wealth index, education, depression, anger, anxiety and chronic stress with the four hormones after adjustment for covariates. RESULTS Higher income-wealth index was associated with lower levels of urinary cortisol, epinephrine, norepinephrine and dopamine, after adjustment for age, sex, race/ethnicity, medication use, body mass index, smoking, and alcohol use. Education and psychosocial factors were not associated with urinary stress hormone levels in the full sample. However, there was some evidence of effect modification by race: SES factors were more strongly inversely associated with cortisol in African Americans than in other groups and anger was inversely associated with catecholamines in African Americans but not in the other groups. CONCLUSIONS Lower SES as measured by income-wealth index in a multi-ethnic sample is associated with higher levels of urinary cortisol and catecholamines. Heterogeneity in these associations by race/ethnicity warrants further exploration.
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671
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Torres P, Romano E, Voas RB, de la Rosa M, Lacey JH. The relative risk of involvement in fatal crashes as a function of race/ethnicity and blood alcohol concentration. J Safety Res 2014; 48:95-101. [PMID: 24529097 PMCID: PMC4080907 DOI: 10.1016/j.jsr.2013.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 12/05/2013] [Accepted: 12/11/2013] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The literature presents a puzzling picture of Latinos being overrepresented in alcohol-related crashes, but not in noncrash drinking and driving. This report examines if, like other demographic variables in which some groups are at a higher crash risk than others (e.g., young drivers), different racial/ethnic groups face different crash risks. METHOD This study compares blood-alcohol information from the 2006-2007 U.S. Fatality Analysis Reporting System (FARS) with control data from the 2007 U.S. National Roadside Survey. Logistic regression, including a dual interaction between BAC and race/ethnicity, was used to estimate crash risk at different BAC levels. RESULTS It was found that, although Hispanic and African-American drivers were less likely to be involved in single-vehicle crashes than their White counterparts, all drivers face similar BAC relative crash risk regardless of their group membership. The overrepresentation of Latino drivers in alcohol-related crashes could be explained by differences in patterns of consumption, driving exposure, lack of awareness of driving rules, and/or socioeconomics.
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Affiliation(s)
- Pedro Torres
- Department of Mathematical Sciences, University of Puerto Rico at Mayagüez, CALL BOX 9000, Mayagüez, PR 00681-9018, USA.
| | - Eduardo Romano
- Pacific Institute for Research & Evaluation, 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA.
| | - Robert B Voas
- Pacific Institute for Research & Evaluation, 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA.
| | - Mario de la Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, PCA 356, 11200 S.W. 8th Street, Miami, FL 33199, USA.
| | - John H Lacey
- Pacific Institute for Research & Evaluation, 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA.
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672
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Gelman A, Miller E, Schwarz EB, Akers AY, Jeong K, Borrero S. Racial disparities in human papillomavirus vaccination: does access matter? J Adolesc Health 2013; 53:756-62. [PMID: 23992645 DOI: 10.1016/j.jadohealth.2013.07.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 06/30/2013] [Accepted: 07/01/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. METHODS We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. RESULTS There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p < .001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR], .76; 95% confidence interval [CI], .50-1.16; and AOR, .67; 95% CI, .37-1.19) but not for African-Americans (AOR, .47, 95% CI, .33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR, .85, 95% CI, .54-1.34; and AOR, .84, 95% CI, .45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR, .49, 95% CI, .36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. CONCLUSIONS Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.
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673
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Richmond TK, Spadano-Gasbarro JL, Walls CE, Austin SB, Greaney ML, Wang ML, Mezegebu S, Peterson KE. Middle school food environments and racial/ethnic differences in sugar-sweetened beverage consumption: findings from the Healthy Choices study. Prev Med 2013; 57:735-8. [PMID: 24036015 PMCID: PMC3912741 DOI: 10.1016/j.ypmed.2013.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 07/17/2013] [Accepted: 09/03/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prior studies have demonstrated disproportionate clustering of fast food outlets around schools. PURPOSE The purpose of this study is to determine if racial/ethnic differences in middle school student self-reported sugar-sweetened beverage (SSB) consumption is explained by differential distributions of food outlets surrounding their schools. METHODS Baseline (2005) data were analyzed from 18,281 middle school students in 47 Massachusetts schools participating in Healthy Choices, an obesity prevention program. Linear mixed effects models were used to examine the association of individual race/ethnicity and daily SSB consumption and the potential mediating effect of the density of food outlets (the number of fast food outlets and convenience stores in a 1500 m buffer area surrounding the school) on this association adjusting for individual and school demographics. RESULTS More SSB consumption was reported by students of all racial/ethnic minority groups compared to their White peers except Asians. The density of fast food restaurants and convenience stores was not associated with individual SSB consumption (β=0.001, p=0.875) nor did it mediate the association of race/ethnicity and SSB consumption. CONCLUSIONS Racial and ethnic differences in SSB consumption among MA middle school students cannot be fully explained by the location of fast food restaurants and convenience stores.
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Affiliation(s)
- Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
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674
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Lowe JR, Nolen TL, Vohr B, Adams-Chapman I, Duncan AF, Watterberg K. Effect of primary language on developmental testing in children born extremely preterm. Acta Paediatr 2013; 102:896-900. [PMID: 23735043 DOI: 10.1111/apa.12310] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 05/24/2013] [Accepted: 05/31/2013] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to better understand the impact of non-English language spoken in the home on measures of cognition, language and behaviour in toddlers born extremely preterm. METHODS Eight hundred and fifty children born at <28 weeks of gestational ages were studied. 427 male and 423 female participants from three racial/ethnic groups (White, Black and Hispanic) were evaluated at 18-22 months adjusted for age using the Bayley Scales of Infant Development third edition and the Brief Infant Toddler Social Emotional Assessment (BITSEA). Children whose primary language was Spanish (n = 98) were compared with children whose primary language was English (n = 752), using multivariable regression adjusted for medical and psychosocial factors. RESULTS Cognitive scores were similar between groups; however, receptive, expressive and composite language scores were lower for children whose primary language was Spanish. These differences remained significant after adjustment for medical and socio-economic factors. Spanish-speaking children scored worse on the BITSEA competence and problem scores using univariate analysis, but not after adjustment for medical and socio-economic factors. CONCLUSION Our finding that preterm children whose primary language was Spanish had similar cognitive but lower language scores than those whose primary language was English suggests that using English language-based testing tools may introduce bias against non-English-speaking children born preterm.
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Affiliation(s)
- Jean R Lowe
- Department of Pediatrics; University of New Mexico School of Medicine; Albuquerque NM USA
| | | | - Betty Vohr
- Brown University School of Medicine; Providence RI USA
| | | | - Andrea F Duncan
- Department of Pediatrics; University of New Mexico School of Medicine; Albuquerque NM USA
| | - Kristi Watterberg
- Department of Pediatrics; University of New Mexico School of Medicine; Albuquerque NM USA
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675
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Painter MA. Immigrant and native financial well-being: The roles of place of education and race/ethnicity. Soc Sci Res 2013; 42:1375-1389. [PMID: 23859737 DOI: 10.1016/j.ssresearch.2013.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 03/25/2013] [Accepted: 04/02/2013] [Indexed: 06/02/2023]
Abstract
Immigrants' integration into U.S. society has occupied the interest of both scholars and the general public throughout the nation's history. This paper draws on and refines dominance-differentiation theory to explore how immigrants' place of education (whether they completed their education in the United States or abroad) and racial/ethnic status differentially affect their ability to integrate into U.S. society. Using the Survey of Income and Program Participation and wealth attainment as an indicator of economic integration, this paper finds mixed evidence for dominance-differentiation theory. Foreign education is associated with lower wealth attainment and race/ethnicity serves as an important stratifying factor for blacks and Latinos; however, there is little support for the theory when comparing the wealth attainment of immigrants with their same-race/co-ethnic native-born peers. This paper concludes with a discussion of why place of education matters for wealth attainment in the United States and explores its implications for both educational and racial/ethnic stratification among U.S. immigrants.
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Affiliation(s)
- Matthew A Painter
- University of Wyoming, 411 Ross Hall, 1000 E. University Avenue, Laramie, WY 82071, United States.
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676
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Weinick R, Haviland A, Hambarsoomian K, Elliott MN. Does the racial/ethnic composition of Medicare Advantage plans reflect their areas of operation? Health Serv Res 2013; 49:526-45. [PMID: 24032551 DOI: 10.1111/1475-6773.12100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess the extent to which the racial/ethnic composition of Medicare Advantage (MA) plans reflects the composition of their areas of operation, given the potential incentives created by the Centers for Medicare & Medicaid Services' Quality Bonus Payments for such plans to avoid enrolling racial/ethnic minority beneficiaries. DATA SOURCES/STUDY SETTING 2009 Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) survey and administrative data from the Medicare Enrollment Database. DATA COLLECTION/EXTRACTION METHODS We defined each plan's area of operation as all counties in which it had MA enrollees, and we created a matrix of race/ethnicity by plan by county of residence to assess the racial/ethnic distribution of each plan's enrollees in comparison with the racial/ethnic composition of MA beneficiaries in its operational area. PRINCIPAL FINDINGS There is little evidence that health plans are selectively underenrolling blacks, Latinos, or Asians to a substantial degree. A small but potentially important subset of plans disproportionately serves minority beneficiaries. CONCLUSIONS These findings provide a baseline profile that will enable crucial ongoing monitoring to assess how the implementation of Quality Bonus Payments may affect MA plan coverage of minority populations.
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677
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Everett BG, Rehkopf DH, Rogers RG. The Nonlinear Relationship between Education and Mortality: An Examination of Cohort, Race/Ethnic, and Gender Differences. Popul Res Policy Rev 2013; 32. [PMID: 24288422 DOI: 10.1007/s11113-013-9299-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Researchers investigating the relationship between education and mortality in industrialized countries have consistently shown that higher levels of education are associated with decreased mortality risk. The shape of the education-mortality relationship and how it varies by demographic group have been examined less frequently. Using the U.S. National Health Interview Survey-Linked Mortality Files, which link the 1986 through 2004 NHIS to the National Death Index through 2006, we examine the shape of the education-mortality curve by cohort, race/ethnicity, and gender. Whereas traditional regression models assume a constrained functional form for the dependence of education and mortality, in most cases semiparametric models allow us to more accurately describe how the association varies by cohort, both between and within race/ethnic and gender subpopulations. Notably, we find significant changes over time in both the shape and the magnitude of the education-mortality gradient across cohorts of women and white men, but little change among younger cohorts of black men. Such insights into demographic patterns in education and mortality can ultimately help increase life expectancies.
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678
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Webb JB, Butler-Ajibade P, Robinson SA, Lee SJ. Weight-gain misperceptions and the third-person effect in Black and White college-bound females: potential implications for healthy weight management. Eat Behav 2013; 14:245-8. [PMID: 23910760 PMCID: PMC3734376 DOI: 10.1016/j.eatbeh.2013.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 03/06/2013] [Indexed: 10/27/2022]
Abstract
Elements of social norm theory and communication theory on the third-person effect may prove useful in efforts to prevent excessive weight gain among emerging adults entering college. The present study explored the associations of race/ethnicity and BMI status with these socio-cognitive factors that may affect first-year weight regulation in a sample of Black (N = 247) and White (N = 94) college-bound females. Participants completed an online survey assessing first-year weight-gain perceived norms along with weight-change expectations and concerns. Results provided evidence of the persistence of the myth of the "Freshman 15", belief in the typicality of gaining weight during the first year of college, and significant concern about first-year weight gain. Initial findings further revealed a robust third-person effect whereby despite nearly 90% of the sample endorsing that first-year weight gain was common, only 12% expected they would experience weight gain. Main effects of race/ethnicity, BMI status, and their interaction further uncovered distinct patterns of findings. Preliminary results highlight the need for college health officials at both predominantly White as well as minority-serving institutions to adequately address the significant concern over first-year weight gain in conjunction with the desire to lose weight expressed by an appreciable number of incoming college females. Findings also advocate the utility of evaluating social norm theory and the third-person perceptual bias in the context of first-year weight gain to potentially enhance the design and effectiveness of healthy weight management initiatives among ethnically-diverse young women entering college.
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Affiliation(s)
- Jennifer B. Webb
- University of North Carolina at Charlotte, Department of Psychology, Charlotte, NC 28223
| | - Phoebe Butler-Ajibade
- North Carolina A & T State University, Department of Human Performance & Leisure Studies, Greensboro, NC 27411
| | - Seronda A. Robinson
- North Carolina Central University, Department of Public Health Education, Durham, NC 27707
| | - Shanique J. Lee
- University of North Carolina at Charlotte, Department of Psychology, Charlotte, NC 28223
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679
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Adjaye-Gbewonyo D, Bednarczyk RA, Davis RL, Omer SB. Using the Bayesian Improved Surname Geocoding Method (BISG) to create a working classification of race and ethnicity in a diverse managed care population: a validation study. Health Serv Res 2013; 49:268-83. [PMID: 23855558 DOI: 10.1111/1475-6773.12089] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2013] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To validate classification of race/ethnicity based on the Bayesian Improved Surname Geocoding method (BISG) and assess variations in validity by gender and age. DATA SOURCES/STUDY SETTING Secondary data on members of Kaiser Permanente Georgia, an integrated managed care organization, through 2010. STUDY DESIGN For 191,494 members with self-reported race/ethnicity, probabilities for belonging to each of six race/ethnicity categories predicted from the BISG algorithm were used to assign individuals to a race/ethnicity category over a range of cutoffs greater than a probability of 0.50. Overall as well as gender- and age-stratified sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Receiver operating characteristic (ROC) curves were generated and used to identify optimal cutoffs for race/ethnicity assignment. PRINCIPAL FINDINGS The overall cutoffs for assignment that optimized sensitivity and specificity ranged from 0.50 to 0.57 for the four main racial/ethnic categories (White, Black, Asian/Pacific Islander, Hispanic). Corresponding sensitivity, specificity, PPV, and NPV ranged from 64.4 to 81.4 percent, 80.8 to 99.7 percent, 75.0 to 91.6 percent, and 79.4 to 98.0 percent, respectively. Accuracy of assignment was better among males and individuals of 65 years or older. CONCLUSIONS BISG may be useful for classifying race/ethnicity of health plan members when needed for health care studies.
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680
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Kposowa AJ. Marital status and HIV/AIDS mortality: evidence from the US National Longitudinal Mortality Study. Int J Infect Dis 2013; 17:e868-74. [PMID: 23562356 DOI: 10.1016/j.ijid.2013.02.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 02/17/2013] [Accepted: 02/18/2013] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The purpose of the study was to examine associations between marital status groups and death from HIV/AIDS. The primary hypothesis was that divorced and single/never married individuals have a much higher risk of death than married persons. METHODS Data were derived from the third release of the US National Longitudinal Mortality Study. Cox proportional regression models were fitted to the data. RESULTS It was found that marital status is associated with mortality from HIV. Divorced and separated individuals were 4.3 times more likely to die of HIV/AIDS than married individuals (adjusted relative risk (aRR) 4.321, 95% confidence interval (CI) 2.978, 6.269). Single/never married persons were 13 times as likely to die of HIV/AIDS as their married counterparts (aRR 13.092, 95% CI 9.652, 17.757). When the sample was stratified by sex, however, it was observed that while marital status was associated with HIV/AIDS mortality among men, it had no significant association with death in women. However, African-American women (aRR 9.23, 95% CI 4.47, 19.03) and Hispanic women (aRR 7.06, 95% CI 3.03, 16.45) had a significantly higher risk of death than their non-Hispanic white female counterparts. CONCLUSIONS Marital status is a significant risk factor for mortality from HIV/AIDS, but this association is only valid for men. The different gender mortality experiences suggest that for HIV/AIDS more population-based studies comprising marital status risk factor histories are needed, given the limited research on marital status and mortality from the disease.
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681
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Abstract
We document racial/ethnic and nativity differences in U.S. smoking patterns among adolescents and young adults using the 2006 Tobacco Use Supplement to the Current Population Survey (n=44,202). Stratifying the sample by nativity status within five racial/ethnic groups (Asian American, Mexican American, other Hispanic, non-Hispanic black, and non-Hispanic white), and further by sex and age, we compare self-reports of lifetime smoking across groups. U.S.-born non-Hispanic whites, particularly men, report smoking more than individuals in other racial/ethnic/nativity groups. Some groups of young women (e.g., foreign-born and U.S.-born Asian Americans, foreign-born and U.S.-born Mexican Americans, and foreign-born blacks) report extremely low levels of smoking. Foreign-born females in all of the 25-34 year old racial/ethnic groups exhibit greater proportions of never smoking than their U.S.-born counterparts. Heavy/moderate and light/intermittent smoking is generally higher in the older age group among U.S.-born males and females whereas smoking among the foreign-born of both sexes is low at younger ages and remains low at older ages. Taken together, these findings highlight the importance of considering both race/ethnicity and nativity in assessments of smoking patterns and in strategies to reduce overall U.S. smoking prevalence and smoking-attributable health disparities.
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Affiliation(s)
- Becky Wade
- Department of Sociology, Rice University, 6100 S. Main Street, Houston, TX 77005
| | - Joseph T Lariscy
- Population Research Center and Department of Sociology, University of Texas at Austin, 305 E. 23rd St, G1800, Austin, TX 78712
| | - Robert A Hummer
- Population Research Center and Department of Sociology, University of Texas at Austin, 305 E. 23rd St, G1800, Austin, TX 78712
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682
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Webster PS, Sampangi S. Report on Data Improvement Project on Patient Ethnicity and Race (DIPPER): pilot design and proposed voluntary standard. R I Med J (2013) 2013; 96:32-35. [PMID: 23638457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The Hospital Association of Rhode Island, in conjunction with the Rhode Island Cancer Registry, received funding for a special project to improve the validity and reliability of race and ethnicity data in hospital inpatient records. In the past year, five hospitals participated in a pilot to improve race/ethnicity data collection. This paper provides an overview of the design and initial implementation of the pilot, and reports on early feedback. Given that the Affordable Care Act strengthens federal data collection efforts, with a new standard issued which adds granularity, these policies can renew efforts to record more accurate and detailed race and ethnicity data. Improved race and ethnicity data will increase our understanding of the health needs of different racial and ethnic groups and health disparities between groups. Better data improves understanding, increases the likelihood of effective actions to address and monitor disparities, and ensure that every American has the opportunity to live the healthiest life possible.
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Affiliation(s)
- Pamela S Webster
- CER special project manager at the Hospital Association of Rhode Island (HARI)
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683
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Abstract
Introduction This study explored the associations between sleep duration and emotion regulation among urban black women (mean age=59 ± 7 yrs). Method Eligible women (n=523) provided sociodemographic data during face-to-face interviews. We used the Comprehensive Assessment and Referral Examination Physical to measure health status; women also estimated their habitual sleep duration. We utilized a modified version of Weinberger’s conceptual model of repression, the Index of Self-Regulation (ISE) to measure emotion regulation. ISE scores were derived by amalgamating the defensive subscale from the Social Desirability Scale and the anxiety subscale from the State-Trait Anxiety Inventory. Results The median habitual sleep duration was 7 hours; 20% of the women were short sleepers (<6 hours) and 6% were long sleepers (>8 hours). Short sleepers, rather than long sleepers, had a greater likelihood of reporting insomnia symptoms than those sleeping 6–8 hours [63.4% vs. 28.1%; Χ2 = 41.87, p<0.001]. In the first logistic regression model, the odds of being a short sleeper for low regulators were 3 times greater than for high regulators [OR = 3.22 95% CI: 2.05–5.06; p<0.0001]. In multivariate-adjusted analysis, OR was reduced to 2.06, but remained significant. In the second logistic model, the likelihood of being a long sleeper among low regulators were 37% greater than for high regulators, but results were not significant [OR=1.37, 95% CI: 0.62–3.01; NS]. Discussion Short and long sleep duration are associated with reduced ability for emotion regulation. Women sleeping 6–8 hrs might be more adept at regulating emotions in their daily lives. Insomnia symptoms might mediate associations between emotion regulations and sleep durations.
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Affiliation(s)
- Christie Racine
- Center for Healthful Behavior Change, Department of Population Health, NYU Langone Medical Centre, NY, USA
| | - Kaushal Kalra
- Department of Family Practice, SUNY Downstate Medical Centre, NY, USA
| | - Mirnova Ceide
- Albert Einstein College of Medicine of Yeshiva University, Department of Psychiatry and Behavioural Sciences, NY, USA
| | - Natasha J Williams
- Center for Healthful Behavior Change, Department of Population Health, NYU Langone Medical Centre, NY, USA
| | - Ferdinand Zizi
- Center for Healthful Behavior Change, Department of Population Health, NYU Langone Medical Centre, NY, USA
| | - Mauro V Mendlowicz
- Department of Psychiatry and Mental Health, Universidade Federal Fluminense, NY, USA ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro, NY, USA
| | - Girardin Jean-Louis
- Center for Healthful Behavior Change, Department of Population Health, NYU Langone Medical Centre, NY, USA
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684
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Abstract
BACKGROUND Little is known about what women value in their interactions with family planning providers and in decision making about contraception. STUDY DESIGN We conducted semistructured interviews with 42 black, white and Latina patients. Transcripts were coded using modified grounded theory. RESULTS While women wanted control over the ultimate selection of a method, most also wanted their provider to participate in the decision-making process in a way that emphasized the women's values and preferences. Women desired an intimate, friend-like relationship with their providers and also wanted to receive comprehensive information about options, particularly about side effects. More black and Spanish-speaking Latinas, as compared to whites and English-speaking Latinas, felt that providers should only share their opinion if it is elicited by a patient or if they make their rationale clear to the patient. CONCLUSION While, in the absence of medical contraindications, decision making about contraception has often been conceptualized as a woman's autonomous decision, our data indicate that providers of contraceptive counseling can participate in the decision-making process within limits. Differences in preferences seen by race/ethnicity illustrate one example of the importance of individualizing counseling to match women's preferences.
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685
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Kimbro RT, Denney JT. Neighborhood context and racial/ethnic differences in young children's obesity: structural barriers to interventions. Soc Sci Med 2012; 95:97-105. [PMID: 23089614 DOI: 10.1016/j.socscimed.2012.09.032] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 06/11/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
Abstract
Numerous studies in the last ten years have investigated racial/ethnic disparities in obesity for young children. Increasing attention is paid to the influence of neighborhood environments - social and physical-on a variety of young children's health outcomes. This work identifies resource-based and community-based mechanisms that impede on the maintenance of healthy weights for young children in socioeconomically depressed areas, and shows consistently higher rates of obesity in more deprived areas. None of this work, however, has explored whether area deprivation or the race/nativity composition of neighborhoods contributes to racial/ethnic disparities in young children's obesity. Utilizing restricted geo-coded data from the Early Childhood Longitudinal Study (Kindergarten) (N = 17,540), we utilize multilevel logistic regression models to show that neighborhood level measures do little to explain racial and ethnic differences in childhood obesity. However, living in neighborhoods with higher levels of poverty, lower levels of education, and a higher proportion of black residents is associated with increased child obesity risk after considering a host of relevant individual level factors. In addition, living in neighborhoods with a higher proportion of foreign-born residents is associated with reduced child obesity risk. Although well-intentioned childhood obesity intervention programs aimed at changing individual-level behaviors are important, our results highlight the importance of considering neighborhood structural factors for child obesity prevention.
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Affiliation(s)
- Rachel Tolbert Kimbro
- Department of Sociology, MS-28, Kinder Institute Urban Health Program, Rice University, 6100 Main St., Houston, TX 77005, USA.
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